Latarjet Procedure for Anterior Shoulder Instability Due to Tramadol-Induced Seizures

Khater, Ahmad Hany; Sobhy, Mohamed H.; Said, Hatem G.; Kandil, Ahmed Wahid; Reda, Wael A; Seifeldin, Ahmed Fouad; Moustafa, Ramez Reda; El-Assal, Maher A.; Kamel, Eman Mohamed

doi:10.1177/0363546515624470

Cited by 12 publications

(20 citation statements)

References 18 publications

(24 reference statements)

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“…To compare to other reports on glenoid pathology in the seizure population, Buhler reported glenoid rim pathology diagnosed on radiographs or arthroscopy in 15 of 34 (44%) shoulders in a group of patients with epileptic seizureinduced shoulder instability, and Thangarajah reported glenoid bone loss in 22% of patients diagnosed by CT or arthroscopy. 7,9 As discussed above and noted by other authors, AEDrelated bone loss 5,9,20,21 and recurrent instability are two likely mechanisms for the increased bone loss seen in this population 35,52 ; however, this is the first study to quantify the rate of bone loss in a surgically managed population of seizure patients relative to controls. In addition to seizures, recurrent dislocation 53,54,55 and revision surgery 56 are both known risk factors for bone loss.…”

Section: Discussionmentioning

confidence: 69%

Surgical Stabilization of Shoulder Instability in Patients With or Without a History of Seizure: A Comparative Analysis

Agha

Rugg

Lansdown

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose:The purpose of this study is to compare patients from a large multicenter cohort with a history of seizure to those without a history of seizure in regard to preoperative and intraoperative findings and surgical procedures performed.Methods: Patients undergoing shoulder stabilization from 2011 to 2018 at 11 orthopaedic centers were prospectively enrolled. Those with a history of seizure were identified and compared to nonseizure controls. Preoperative demographic, history, physical examination, and imaging findings were collected. Intraoperative findings and surgical procedures performed were recorded. Mann-Whitney tests, Chi Square tests, and logistic regression analysis were employed to examine differences between the groups and define independent risk factors. Due to the number of statistical tests performed, the false discovery method was employed to determine adjusted P values to achieve α < .05. Results:During enrollment, 25 of 1298 shoulder stabilization patients had a history of seizure (1.9%). Sex ratio and age were similar between groups, as was posterior instability incidence (control: 23.2%; seizure: 28.0%). Seizure patients more frequently had >5 dislocations in the year preceding surgery (P = 0.016) and had increased preoperative radiographic evidence of bone loss

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Section: Discussionmentioning

confidence: 69%

Surgical Stabilization of Shoulder Instability in Patients With or Without a History of Seizure: A Comparative Analysis

Agha

Rugg

Lansdown

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Of the 26 included studies, recurrent instability was defined by recurrent dislocation only in 9 studies, 1 , 2 , 5 , 8 , 14 , 24 , 33 , 35 , 41 dislocation or subluxation in 13 studies, ∥ and dislocation, subluxation, or positive apprehension in 3 studies, 29 , 53 , 54 although 1 study did not report on recurrent instability. 9 Overall, recurrent instability was reported in 95% (n = 19 of 20) of studies examining the traditional Latarjet procedure and 100% (n = 6 of 6) of studies describing the congruent arc technique.…”

Section: Resultsmentioning

confidence: 99%

Clinical Outcomes of the Traditional Latarjet Versus the Congruent Arc Modification for the Treatment of Recurrent Anterior Shoulder Instability: A Meta-analysis

Mengers

Knapik

Kaufman

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Few studies have compared clinical outcomes between the traditional Latarjet procedure for anterior shoulder instability and the congruent arc modification to the Latarjet procedure. Purpose: To systematically evaluate the literature for the incidence of recurrent instability, clinical outcomes, radiographic findings, and complications for the traditional Latarjet procedure and the congruent arc modification and to compare results of each search. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review and meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We included studies published between January 1990 and October 2020 that described clinical outcomes of the traditional Latarjet and the congruent arc modification with a follow-up range of 2 to 10 years. The difference in surgical technique was analyzed using a chi-square test for categorical variables, while continuous variables were evaluated using a Student t test. Results: In total, 26 studies met the inclusion criteria: 20 studies describing the traditional Latarjet procedure in 1412 shoulders, and 6 studies describing the congruent arc modification in 289 shoulders. No difference between procedures was found regarding patient age at surgery, follow-up time, Rowe or postoperative visual analog scores, early or late complications, return-to-sport timing, or incidence of improper graft placement or graft fracture. A significantly greater proportion of male patients underwent glenoid augmentation using the congruent arc modification versus traditional Latarjet ( P < .001). When comparing outcomes, the traditional Latarjet procedure demonstrated a lower incidence of fibrous union or nonunion ( P = .047) and broken, loose, or improperly placed screws ( P < .001), and the congruent arc modification demonstrated improved outcomes with regard to overall return to sport ( P < .001), return to sport at the same level ( P < .001), incidence of subluxation ( P = .003) or positive apprehension ( P = .002), and revision surgery for recurrent instability ( P = .027). Conclusion: Outcomes after the congruent arc modification proved at least equivalent to the traditional Latarjet procedure in terms of recurrent instability and return to sport, although early and late complications were equivalent. The congruent arc procedure may be an acceptable alternative to traditional Latarjet for the treatment of anterior shoulder instability with glenoid bone loss; however, long-term outcomes of this procedure are needed.

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“…Tramadol has a lower incidence of respiratory depression, gastrointestinal side effects, and dependence compared with traditional opioids 38 . Side effects include a rare risk of lowering the seizure threshold and the development of serotonin syndrome 39,40 . Tapentadol is another synthetic opioid that functions as a centrally acting analgesic with a similar mechanism of action; however, it does not block serotonin reuptake, thus attenuating the risk of serotonin syndrome 41 .…”

Section: Central Acting Analgesicsmentioning

confidence: 99%

Perioperative Pain Management in Ambulatory and Inpatient Shoulder Surgery

et al. 2021

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Acetaminophen is an effective addition to a multimodal pain regimen; however, evidence to support intravenous versus oral administration requires further evaluation.While nonsteroidal anti-inflammatory drugs are a valuable addition to a multimodal pain strategy, concerns regarding their effect on healing after certain procedures (i.e., rotator cuff repair) in select patients may preclude their use.The use of perioperative gabapentinoids have varied results for pain control, and additional research is warranted to support their use after certain shoulder procedures.Opioid-prescribing should be limited and reserved for severe postoperative pain. When prescribed, opioids should be taken at the lowest possible dose and for the shortest period.Centrally acting analgesics such as tramadol have been shown to be as effective as opioids and have a lower risk of complications.Nerve blocks are an excellent addition to multimodal pain management strategies. Longer-lasting formulations of perioperative single-shot injections and indwelling catheters may reduce rebound pain.

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Latarjet Procedure for Anterior Shoulder Instability Due to Tramadol-Induced Seizures

Cited by 12 publications

References 18 publications

Surgical Stabilization of Shoulder Instability in Patients With or Without a History of Seizure: A Comparative Analysis

Surgical Stabilization of Shoulder Instability in Patients With or Without a History of Seizure: A Comparative Analysis

Clinical Outcomes of the Traditional Latarjet Versus the Congruent Arc Modification for the Treatment of Recurrent Anterior Shoulder Instability: A Meta-analysis

Perioperative Pain Management in Ambulatory and Inpatient Shoulder Surgery

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